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Expat Essential Member Guide

Manage your Expat Essential Policy

Our mission is to ensure our members live healthier, longer lives by providing them brilliantly simple
health insurance plans.

The purpose of this member's guide is to guide you through your health insurance procedures including:
  • Arranging medical treatment
  • How to claim
  • Ways to contact us

 

Understanding Your Hospital Copayments 

Your Expat Essential plan includes copayments at designated hospitals listed below. Covered eligible expenses at these hospitals will be subject to the applicable copayment. This list may be updated periodically and members will be notified of any updates affecting their coverage.

Hospitals with 30% Copayment

At these hospitals, you pay 30% of covered eligible expenses:

  • Bumrungrad International Hospital - Thailand

  • Medpark Hospital - Thailand

  • Kuta Emergency (Lombok) - Indonesia

  • Nusa Medica Clinic Group - Indonesia

  • Sunrise Japan Hospital - Cambodia

  • Royal Phnom Penh Hospital - Cambodia

  • Gleneagles Hospital Singapore - Singapore

  • Mount Elizabeth Novena Hospital - Singapore

  • Mount Elizabeth Hospital (Orchard) - Singapore

  • Raffles Hospital - Singapore

  • Bangkok Hospital Samui - Thailand

  • Bangkok Hospital Pattaya - Thailand

  • Kasemrad International Hospital Vientiane - Laos

Hospitals with 10% Copayment

At these hospitals, you pay 10% of covered eligible expenses:

  • Bangkok Hospital Chiang Mai - Thailand

  • Chiangmai Ram Hospital - Thailand

  • Vejthani Hospital (Bangkok) - Thailand

  • BNH Hospital (Bangkok) - Thailand

  • Wattanapat Hospital Samui - Thailand

  • Phyathai Sriracha General Hospital - Thailand

  • Bangkok Hospital Hua-Hin - Thailand

  • San Paulo Hua Hin Hospital - Thailand

  • Bangkok Hospital Siriroj (Phuket) - Thailand

  • Bangkok Hospital Phuket - Thailand

  • Bangkok Hospital International (Bangkok) - Thailand

  • Bangkok Hospital Udon - Thailand

 

Arranging Medical Treatment

Choice of Medical Facilities

You are entitled to choose any accredited medical facilities you prefer. If you do not wish to pay upfront for your medical treatment, we recommend that you choose one of the medical providers (i.e. hospitals/clinics) in our network.

To provide a seamless experience for LUMA members, we have established a preferred medical network of Hospitals and Clinics with direct billing. Direct billing is a cashless service allowing LUMA members to check-out without upfront payment of their treatment.

Important: Hospital Copayments at Network Facilities

Please note that certain network hospitals require copayments under your Expat Essential plan. At the designated hospitals listed above, you will be responsible for paying your copayment percentage (10% or 30%) at the time of treatment, while the insurer covers the remainder through direct billing.

Note that providers in LUMA's Medical Network simply facilitate the billing process by sending your medical bills directly to us for review and payment. 

It's crucial to understand that direct billing providers cannot define or confirm if a specific treatment is covered under your health plan. Factors like policy exclusions, underwriting terms, benefit limits, deductibles and co-payments may result in charges not being covered by your insurance. In such cases, you may be billed directly by the healthcare provider. If we've already paid a claim on your behalf and it turns out to be ineligible, we may seek recovery from you.

Consult LUMA Medical Network.
Credit card imprint may be required in some major hospitals.

For out of network providers: If you visit a healthcare provider that doesn't offer direct billing, please pay your medical expenses upfront. You can then submit a claim to us along with the necessary documentation for our review. 

 

Expat Essential: How to Claim

Required documents:

  • Receipt
  • Medical report / certificate
  • Detailed receipt (statement detail report including name of medicine and price of each items to be mentioned, if any)
  • Doctor’s prescription (with medical indications for prescription drugs, laboratory tests, physical therapy, eyeglasses and contact lenses)

Expat Essential members with Outpatient benefits can submit claims online for amounts up to 10,000 USD. Original documents are required for claims exceeding 10,000 USD.

Important Guidelines for Online Claim Submission:

  1. Please keep the original receipts for 12 months from the date of claim payment. The insurer reserves the right to request original documents for verification. If the insured fails to provide the original documents upon request, the insurer reserves the right to deny the claim and pursue recovery. 
  2. You can make an online submission for claims exceeding 10,000 USD to expedite the review process. After online submission, please send the documents by post to process the claims. 

If requested, please send original documents to this address:

LUMA, Claims Department
57 Park Ventures Ecoplex
9th Floor, Unit 912 Wireless Road,
Lumpini, Pathumwan, Bangkok 10330 Thailand

 

 

Mobile Application / Member Portal

 

 

Policy Management

 

 

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